Objective. To compare the intensity of pain-relieving effect of percutaneous vertebroplasty (PV) in patients with gemangiomas, osteoporotic vertebral fractures, and malignant metastases. Matherial and Methods. 210 percutaneous vertebroplasties (VP) were performed in 121 patients at the age of 18 to 87 years. Out of them 22 patients had metastases into vertebral body/bodies, 72 patients – osteoporotic fractures, and 27 patients – vertebral haemangiomas with high-grade pain syndrome. The levels of vertebroplasty were between T3 and S1, predominantly (178 cases) from T9 to L4 levels. Significant anatomic abnormalities in seven cases required CT-guidance of the percutaneous vertebroplasty. Pain syndrome intensity before and after PV was assessed by visualanalogue scale. Results. Percutaneous vertebroplasty resulted in significant pain relief in all patients. One hundred-and-one patients reported full satisfaction with treatment, 17 patients – partial satisfaction, and 3 patients were not satisfied. Vertebroplasty complicated by cement leakage into the spinal canal in two patients with multiple myeloma. One patient with osteoporotic fractures has developed L5 radiculopathy after four-level PV, which was eliminated in 5 days. Three patients had transient complications. Conclusion. The achieved results confirm a high painrelieving efficacy of percutaneous vertebroplasty. A choice of vertebroplasy technique depends on a nature of pathology and peculiarities of vertebral anatomy. Application of cement based on calcium phosphate, bioceramic and bone morphogenetic proteins improves the long-term outcomes of percutaneous vertebroplasty.
Objective. To analyze the outcomes of sacroplasty in patients with low-energy sacral fractures. Matherial and Methods. Sacroplasty was performed in 20 patients for persistent pain caused by low-energy sacral insufficiency fracture. The procedure involved bone cement injection under the guidance of CT fluoroscopy. The pain intensity was assessed with the Visual Analog Scale (VAS) preoperatively, one day, one month and three months after surgery. Results. In each case a needle was inserted precisely into the site of fracture. Pain intensity in the sacral region at the next day after sacroplasty was 5.7 scores on the VAS. Sixteen patients underwent follow-up examination in a month. The average VAS score was 4.1. In three months 12 patients were examined. They assessed their pain perception as 2.3 score. All examined patients were able to walk independently without pain. Conclusion. Sacroplasty provides long-term pain relief and improves quality of life in patients with low-energy sactral insufficiency fractures. The sacroplasty advantages are minimal intraoperative tissue trauma, low risk of intraand postoperative complications, and relatively low cost of treatment.
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